BIOMEDICAL INTERVENTIONS

Biomedical intervention for Autism
or Asperger’s
syndrome consists of a wide range of therapeutic approaches
for treating these developmental disorders in children, adolescents,
and possibly adults. A major problem for most biomedical interventions
is not meeting the criteria as evidence-based
treatments due to a lack of rigorous research. This does not
necesarily mean biomedical interventions won't help, but caution
and personal research are recommended.

The case for and against Biomedical intervention

Some parents and medical professionals report
improvements in the behavior of autistic children enrolled in restrictive
diets, detoxification therapies, and a range of treatments, collectively
known as biomedical intervention for Autism. Some of these claims
are contested by specialist doctors, who fear that the failure of
conventional medicine to address parental concerns, and the meager
resources committed to scientific research, has led to Autism and
Aspergers syndrome becoming a magnet for quacks and charlatans.

Others believe that without rigorous
testing, it is easy to see improvements as a ‘cure’ when they
may have been due to the placebo effect, or simply natural development.
Others believe these therapies don't actually treat Autism or Asperger's
syndrome but rather help with the comorbid
conditions often associated with Autism Spectrum Disorders.

There is plenty of anecdotal evidence to support biomedical intervention
– some parents who try one or several therapies report some progress,
and there are stories of children who have undergone these programs
and become seemingly completely neurotypical, able to return to
mainstream education. However, this evidence may be confounded by
the dramatic improvements often seen in autistic children as they
grow up, with or without such interventions. There are calls for
double-blind studies regarding various treatment approaches.

Theory behind Biomedical intervention

The premise for biomedical intervention is that
certain neurological disorders are caused by environmental shocks
that in turn compromise the children's gastrointestinal,
immunological and neurological systems. Based on this premise, what
is often diagnosed as Autism, Asperger's or other Autism Spectrum Disorders may be a physiological syndrome that can and should be
treated as a physiological disorder. This runs contrary to scientific
consensus on what is likely to be the cause
of Autism and other Autism Spectrum Disorders.

Problems in these three areas are seen to be:

Gastrointestinal

Children with Autism or Asperger’s tend toward
constipation or diarrhea
and often have abnormal cravings for certain kinds of food

Immunological

Autistic children are prone to allergies, migraines,
and react abnormally to infectious diseases

Neurological

Children with Asperger’s or Autism are consistently
hypo- or hypersensitive to sensory
impressions.

General improvement is claimed in all three systems with a restrictive
diet, with regression if the diet is then unrestricted. A major
problem with the model is that the above problems do not appear
in the Autism diagnostic criteria but are rather comorbid conditions.

This point of view is consistent with wider evidence
that diet and nutrition can affect behavior generally, but there
is no medical literature evidencing claims that Autism can be fully
cured. Some of the most prominent advocates of various therapies
have autistic children who manifestly display serious behavioral
difficulties.

What is a typical approach to Biomedical intervention?

Biomedical intervention usually starts with a
restrictive diet, such as the gluten-free, casein-free diet. Typically,
foods will be restricted in a particular sequence, for example by
eliminating:
• Dairy products - casein and/or lactose
• Gluten, found in grains such as wheat, barley, rye, oats, spelt,
etc.
• Eggs, nuts, and berries that are known provoke allergic reactions
in children
• Fruits and vegetables that contain salicylates, phenols, and other
reactive substances
• All artificially colored food, i.e., the Feingold Diet
• All bi- and poly-saccharides, such as lactose, fructose, starch,
etc. (the Specific Carbohydrate Diet).

Parents report varying success with these diets,
and combinations of them. Some have seen major benefits simply from
eliminating milk; others need to eliminate salicylates or phenols
to reach a tipping point; others have found a workable, effective
diet in the Specific Carbohydrate Diet. Many parents report no benefit
from a restrictive diet at all.

LEVELS OF PROOF AND POTENTIAL HARM OF BIOMEDICAL
INTERVENTIONS

Levy and Hyman (2002) reviewed the safety and
effectiveness of non-traditional approaches to the treatment of
Autism according to evidence-based
criteria, and divided treatment approaches into the following
categories:

• unproven benign biological treatments that have
some basis in theory
• unproven benign biological treatments that are commonly used but
have no basis in theory
• unproven, potentially harmful biological treatments.

Using these categories, biomedical interventions
could be categorized as:

Unproven but some basis in theory

• Gluten and casein free diets

• Vitamin C

• Secretin.

Unproven and no basis in theory

• Vitamin B6 and Magnesium

• Gastrointestinal medications

• Antifungal agents.

Unproven and potentially harmful

• Chelation

• Immunoglobulins

• Large doses of Vitamin A

• Antibiotics

• Antiviral agents

• Alkaline salts

• Withholding immunizations.

a brieF introduction to some BIOMEDICAL INTERVENTIONS

Gluten-free diet for autistic children

Dr. Karl Ludwig Reichelt claims to have found
peptides from casein and gluten that worsen the symptoms of autistic
children, many of whom have digestive disorders. These peptides
are casomorphines and gluten exorphins, which influence the brain.
The primary proponent of the possible link between digestive disorders
and Autism is Dr. Andrew Wakefield, a United Kingdom gastroenterologist
who has described the disputed condition as autistic enterocolitis.

According to Dr. Reichelt, significant improvement
has been seen in the symptoms of some of his patients with Autism
who had been put on a diet that omits these peptides. The diet is
called the gluten-free, casein-free diet. Some physicians see diet
as a central part of the treatment, but in addition to many other
treatments at the same time. See the Casein
and gluten-free diet fact sheet for more information.

Medication as an autistic intervention

The benefits of drugs is widely disputed. There
are many parents whose children have experienced dramatic improvements
in certain behavioral issues or comorbid disorders with correctly
prescribed medication. However, while anti-seizure medication is
indicated for some children with seizures, many parents are opposed
to using psychopharmacology to treat their children. Many autistic
people themselves are against the overprescription of neuroleptic
drugs in autistic people to control behavior whilst some of those
with co-morbid disorders have been relieved to have medication to
manage these and some psychiatrists are just now beginning to explore
minimal doses of medication for this group. See the Drug
therapy fact sheet for more information.

Vitamins and herbs for autistic children

The use of high doses of vitamin B6 with or without
magnesium is gaining popularity among parents. Some studies do validate
its effectiveness; including some double-blind ones. However, there
appear to be some significant risks associated with high doses of
vitamin B6, including peripheral neuropathy. Some people argue that
vitamin B6 only helps children in the following groups:
• Those with nutritional deficiencies (ie.fussy eaters)
• Those with vitamin B6 deficiency (related to seizures).

The Ayurvedic herb bacopa has been used in several cases of Autism
with promising effect according to anecdotal evidence. Bacopa is
used medicinally in India for memory enhancement, epilepsy,
insomnia, and as a mild sedative. This herb commonly grows in marsh
areas throughout India. Some studies have shown that Bacopa has
antioxidant effects specific to the cerebral tissue. See the Vitamins
& herbs fact sheet for more information.

Detoxification as an Autism therapy

Based on the speculation that heavy metal poisoning
may trigger the symptoms of Autism, particularly in small subsets
of individuals who cannot excrete toxins effectively, some parents
have turned to alternative medicine practitioners who provide detoxification
treatments, via chelation therapy, as a treatment method. However,
evidence to support this practice has been anecdotal and not rigorously
tested.

Furthermore, there is strong epidemiological evidence
that refutes links between environmental triggers, in particular
thimerosal containing vaccines, and the onset of autistic symptoms.
The death of a five-year-old boy in August 2005 has been linked
to this practice; however, the isolated case has been attributed
to the accidental administration of an incorrect agent. In this
instance, the death was due to the administration of disodium EDTA
instead of calcium disodium EDTA. See the Detox
fact sheet for more information.

Low Salicylate diet

Researchers such as Rosemary Waring (Birmingham
University) found a significant proportion of people with Autism
were Salicylate-intolerant, meaning they were unable to properly
metabolize Salicylates ; a natural plant toxin common in most stone
fruits, berries, citrus fruits (with the exception of lemon), some
vegetables and very high in honey, yeast extracts and almonds. The
low Salicylate diet is commonly known of in ADHD/ADD circles as
the Feingold Diet and includes eliminating artificial colorings,
flavorings, preservatives and nitrates. Salicylate intolerance has
been particularly linked to attentional problems and hyperactivity
but more recently to mood and anxiety disturbances. See the Low
salicylate diet fact sheet for more information.

Gold salts

Gold salts have recently come into focus as a
potential treatment for Autism. Boyd Haley, a University of Kentucky
professor and leading proponent of the much disputed mercury-Autism
hypothesis (see Have
vaccinations caused Autism?), has suggested that gold salts
may reverse conditions attributed to mercury administration in the
form of thimerosal that was used as a preservative in vaccinations
until recently. See the Gold
salts fact sheet for more information.

Holistic healing

Evidence exists which may explain why the individual
therapies listed above do not necessarily work for all sufferers
of Autism. A more comprehensive approach may be required, in which
the genetics of each individual Autism sufferer is studied and understood,
followed by a personalized therapy schedule which may include diet
restrictions, heavy metal detoxification, vitamin supplementation,
etc.

Probiotic diet for Autism or Asperger's

Probiotics are dietary supplements containing
potentially beneficial bacteria or yeast. The use of probiotic diets
for children with Autism has been reported to have improved the
concentration and behavior of the study subjects so much that medical
trials collapsed because parents refused to accept placebos.

According to the researchers, the effectiveness
of the treatment caused some of the parents involved in a blind
trial to realize that their children were not taking a placebo.
The parents then refused to switch to the placebo as scheduled,
resulting in the collapse of the trial. As a result, it was difficult
for researchers to draw firm conclusions. Further research is being
planned. See the Probiotic
diets fact sheet for more information.

Click here for the full
range of Asperger's and Autism fact sheets at www.autism-help.org
This autism fact sheet is licensed under the GNU
Free Documentation. It is derivative of an Autism and Asperger's
syndrome-related articles at http://en.wikipedia.org